Shockwave Therapy for E.D.Home » Alternative E.D. » Shockwave Therapy for E.D.

Some men simply do not respond well to PDE5 Inhibitors and/or standard testosterone therapy to solve their erectile dysfunction.  They need a bigger gun.  Shockwave therapy is one of the new treatments that has come out to help such men.  It is not cheap, but the research look promising at least.  It has the ability to actually create new vascular tissue inside the penis and who can argue with that?

Shockwave therapy as an aid to sexual potency has been pioneered by Yoram Vardi, an Israeli Urologist. Similar technology has been used in other areas of medicine, including treating shoulder or ankle injuries, coronary artery disease, and bone fractures, for more than twenty years; though not all authorities fully accept its effectiveness.

An American company, Medispec, who have made shockwave machines for eighteen years, introduced the ED-1000 to provide erection-enhancing treatment in 2011. This device resembles a wheeled photocopier, with a probe on a flexible tube to deliver the shocks

The Medispec video claims the ED-1000 provides a permanent cure for erectile dysfunction, and works for both those who respond to PDE5i and those who don t, and that half of their patients who once used a PDE5i no longer need to.

The standard ED-1000 therapy consists of two sessions a week for three weeks, three weeks without treatment, and then a repeat of the first three weeks. Each twenty minute session involves 1500 low-intensity shockwaves applied to five points on and under the penis. This is said to encourage miniscule new blood vessels to grow within the flesh of the penis, and to break up plaque that is causing a hardening of the existing arteries, enabling a better blood flow.

My Experiences. I started the ED-1000 course on 28th November 2012 (about four weeks after starting Prelox) and finished on 31st January 2013.

Sessions 4, 5 & 6 were slightly uncomfortable, and my penis felt delicate, with reduced erectile function for around 24-48 hours after each session, – which I am told is unusual. I detected little or no general change in erectile function before the sixth session. But during the three week treatment-free period I noticed improvements in nocturnal and p**n-induced erections.

The start of the second treatment period coincided with a significant improvement. I had more npt immediately following session 7 than I ve had for many years; and p$$n-induced erections seemed much easier too. Session 8, two days later, seemed strangely to have the opposite effect, which lasted till sessions 9 & 10 which coincided with restoration of the improvements. However, after session 10, I stopped self-testing , and I ceased seeing my girlfriend, and so can t report on erections on or soon after sessions 11 and 12. Nevertheless, by the end of the course I felt disappointed. I had been to bed with a new girlfriend three times in January and they were three of my worst ever performances. I wasn t even conscious of nerves in my last attempt (between sessions 10 and 11). My real-world performance was worse in January 2013 than ever, but my p__nography-assisted performance better than ever.

Further sexual activity in summer 2013 with a new partner showed no better erectile function, – even though PDE5i assisted.

What I euphemistically call self-testing got out of hand after a couple of failures with a long-term partner in October 2012, and particularly out of hand after the great stress of losing her in November 2012, and there was further excessive self-testing during the nine weeks of shockwave therapy. Perhaps overdosing on p__nography may have overwhelmed the benefit of the shockwaves when faced with a real naked woman loose in my bedroom?

Perhaps more than twelve shockwave sessions could offer greater benefit. Medispec advise that the treatment can be repeated as often as necessary. But if the problem is mainly in my head, then LI-ESWT can have only limited benefit.

Nevertheless I started another six shockwave session on 20th August 2013. The first four sessions felt even more sensitive than before, but there has been significantly more npt than usual.

Now let’s look at the details of some of the research that supports Shockwave Therapy and its effectiveness.

Clinical Trial 1. The first of Professor Vardi s trials reported, in 2009, that fifteen of twenty patients (each with an initial IIEF-EF score of between 5 and 19, and who responded to PDE5i) benefited, and their improvement, in Vardi s words, was a huge improvement . At the six month follow-up it was found that ten of the men no longer needed PDE5i. Seven of the twenty had their IIEF-EF score improved by ten or more points. Eleven had at least a seven point improvement; and fifteen had at least a five point improvement (all without PDE5i). Two of the improved fifteen had, at the follow-up, declined a little and needed further treatment. Three of the twenty patients achieved no increase, or a reduction, in score. Only two men on the course had no risk factors (such as high blood pressure, heart disease, or diabetes) and both no longer needed to take PDE5i following the course. Ten men increased their IIEF-EF score between the one-month follow-up and the six- month follow-up, and seven reduced.

Only men thought to have abnormal nocturnal penile tumescence were allowed onto the first trial, as that suggested a arteriogenic cause for their dysfunction. However the npt measurements proved unreliable and difficult to interpret, and this requirement was not part of the screening process in the two later trials.

Clinical Trial 2. The second Vardi trial, on 29 more severely affected men, who suffered generally with poor health (21 being diabetics) and who responded poorly, or not all, to PDE5i, also found worthwhile results. The average increase in IIEF-EF score was 10 points after treatment, – whilst on PDE5i (to which they were now better able to respond). Eight men were normalised (in the words of the report). 22 of the 29 men improved their IIEF score by at least five points.

The patients on both trials were all long-term sufferers. Improvement in erectile function became apparent between the sixth and eighth session.

Clinical Trial 3. More recently Professor Vardi reported, at the European Association of Urology annual conference in 2012, that the first placebo-controlled double-blind trial found that the treated group experienced a significantly greater increase in the IIEF Total Satisfaction category than the sham group. (There were twenty men in the sham group, and forty in the treated group.)

The patients were screened to avoid certain medical conditions and they had to be able to achieve an IIEF-EF score of at least 19 whilst on PDE5i, though no PDE5i was allowed during the trial. Without PDE5i the mean average baseline score was a low 12.6. Only 12.5% of patients were mildly dysfunctional.

The average increase in the IIEF-EF score of the whole treated group was 6.7 by the first follow-up, four weeks after treatment; and was a worthwhile 3.0 in the sham group. You might interpret this as LI-ESWT offering only an average 3.7 point increase over a placebo.

An article on this third trial by Vardi and his associates, in the May 2012 Journal of Urology , reported that 23 of the men (16 from the sham group) elected to have further treatment. The 36 remaining men who attended the 3 month second follow-up, increased their average IIEF-EF score from 20.7 at the first follow-up to 22.1. This from a low baseline was an impressive average improvement.

Possibly the most striking part of the trial related to firmness or erections. The Erectile Hardness Scale measures the firmness of erections on a scale of 1 to 4. Three is just adequate for penetration, and four is the ideal. The sham treatment reduced (by one) the number men who could achieve EHS3. But of the 40 men in the treated group the number able to achieve EHS3 increased from 12 to 31

The trial also used Flow Mediated Dilation tests to measure the penile blood flow in the two groups to give an objective view of the results of the treatment. Only the treated group showed an increase, and it was a large increase.

The report seems to accept that the treatment may not generally offer quite the improvement that PDE5i initially can.

The article stated that no deleterious side effects have been reported, – despite findings that such shock waves may lead to the collagenisation of corporal smooth muscle in rats. The report warned the long term risk of LI-ESWT on penile tissues has not yet been fully elucidated .

Treatment. Several clinics offer this treatment. One is St Peter s Andrology Centre at 145 Harley Street, who has offered the treatment since late September 2012. There is a 300 consultation fee, and the course costs 3500, which includes a follow-up consultation a few weeks after the course. (The cost is significantly cheaper in Hove, Swindon, Manchester and Edinburgh.)

Dr. Philip Kell, of the St. Peter s Andrology Centre, told me in November 2012 that he had completed treatment on ten patients, all of whom had more severe symptoms than I, with most considering of implants as their next step, as PDE5i and/or Muse/Caverject weren t working. He thought about half were significantly improved. Dr. Kell was treating patients with more severe problems than Professor Vardi; and Professor Vardi is surely more instinctively enthusiastic about his own treatment. Furthermore Vardi s patients often seemed to improve for several months after the treatment, whereas the Harley Street patients had only just finished their course.

Rival shockwave machines, from Renova and Vertec, which claim to work faster, with just four thirty-minute sessions, are also available. Mr. Gordon Muir, also of Harley Street, has the first Renova machine, and has a special offer of 1250 for the four sessions, – plus 230 consultation fee)

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